摘要
[目的]比较聚醚醚酮(polyether ether ketone,PEEK)与钛合金材质挤压螺钉前交叉籾带(anterior cruciate ligament,ACL)重建术对移植物-骨愈合的影响。[方法]2017年10月-2019年10月,ACL损伤患者106例纳入本研究。将患者随机分为两组,各53例。均采用LARS人工軔带行ACL重建术,PEEK组采用PEEK螺钉,而钛合金组采用钛合金挤压螺钉固定移植物。比较两组临床、实验室检测和影像资料。[结果]两组患者均顺利完成手术。与术前相比,末次随访时两组患者的Lachman试验和轴移试验的稳定性均显著改善,Lysholm评分和膝伸屈ROM增显著增加(P<0.05)。PEEK组在Lachman试验和轴移试验的稳定性,以及Lysholm评分和膝伸屈ROM均显著优于钛合金组(P<0.05)。实验室检测方面,与术前相比,术后2个月两组的血浆白蛋白、球蛋白,血清补体C3、补体C4水平比较均无显著变化(代>0.05)。相应时间点,两组间血浆白蛋白、球蛋白,血清补体C3、补体C4水平的差异均无统计学意义(P>0.05)。影像方面,随术后时间推移,两组骨隧道扩大显著增加(P<0.05),相应时间点PEEK组骨隧道扩大均显著小于钛合金组(P<0.05)。[结论]PEEK挤压螺钉具有良好的生物相容性和力学特性,更有利ACL重建移植物与骨的愈合。
[Objective]To compare the effect of polyetheretherketone(PEEK)versus titanium alloy(TA)interference screws on graft-bone healing in anterior cruciate ligament(ACL)reconstruction.[Methods]From October 2017 to October 2019,106 patients with ACL injury were included in this study.The patients were divided into two groups with 53 cases in each group.All the patients underwent ACL re-constructions with LARS graft,PEEK screws were used in the PEEK group,while TA screws were used to fix the graft in the TA group.The clinical,laboratory and imaging data were compared between the two groups.[Results]All patients in both groups had operation completed smoothly.The stability in terms of the Lachman test and pivot-shift test significantly improved,additionally,the Lysholm score and knee extension-flexion range of motion(ROM)increased significantly in both groups at the latest follow-up compared with those preoperatively(P<0.05).The PEEK group proved significantly superior to the TA group in terms of stability revealed by the Lachman test and axial shift test,as well as Lysholm score and knee extension-flexion ROM postoperatively(P<0.05).Regarding to laboratory test,there were no significant changes in the levels of plasma albumin,globulin,serum complement C3 and complement C4 at 2 months after surgery compared with those preoperatively(P>0.05),and no significantly differences in abovesaid laboratory parameters were noted between the two groups at any matching time point(P>0.05).In terms of imaging evaluation,enlargement of bone tunnels increased significantly over time in the two groups(P<0.05),however,the PEEK group had significantly less bone-tunnel enlargement than the TA group at all the corresponding time points(P<0.05).[Conclusion]The PEEK interference screw has good biocompatibility and mechanical properties,which is more conducive to the graft-bone healing in ACL reconstruction.
作者
田科
毕方刚
李鹏举
TIAN Ke;BI Fang-gang;LI Peng-ju(The Sixth Branch,Department of Orthopedics,The First Affiliated Hospital,Zhengzhou University,Zhengzhou 450000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第20期1848-1852,共5页
Orthopedic Journal of China
基金
河南省科技攻关计划项目(编号:22170139)。
关键词
前交叉韧带重建术
移植物-骨愈合
聚醚醚酮螺钉
钛合金螺钉
anterior cruciate ligament reconstruction
graft-bone healing
polyetheretherketone screw
titanium alloy screw
